Medicare Cost Reporting Auditor (Full-time, Remote) Jobs in Alexandria, United States


Full-Time EmployeeRemotehttp://www.integritym.comAbout UsIntegrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.At IntegrityM, we offer a culture of opportunity, recognition, collaboration, and supporting our community. We thrive off of these fundamental elements that make IntegrityM a great place to work. Our small, flexible workplace offers an exceptional quality of life and promotes corporate-driven sustainability. We deliver creative solutions that exceed goals and foster a dynamic, idea-driven environment that nurtures our employees’ professional development. Large company perksSmall company feel!In this role, the Auditor will be responsible for analyzing, investigating and reporting on hospital reported resident data used to calculate program payment appropriateness for grant funding under the requirements of HRSA’s Full-Time Equivalent (FTE) Graduate Medical Education (GME) Program.Audit assignments are both financial and programmatic and may range from desks and/or field reviews, as determined by the Agency and/or Program requirements. Each audit will include the review and analysis of Medicare Cost Reports (MCR) data, CMS Intern amp; Resident Information System (IRIS) data, program payment appropriateness (grants, loans etc.), policy compliance as well as research and analysis of industry trends. The HRSA Auditor will work independently as well as collaboratively with other audit staff, per the direction of the Audit Program Director and under the supervision of the Audit Manager. Primary Job Responsibilities:Examine and calculate data from financial documents and statements including Medicare Cost Reports, Medicare Administrative Contractor (MAC) data and grant program applications, as a method of audit Application of CMS/HRSA formulas used to determine allowable resident time under a Full-Time Equivalent Graduate Medical Education Program Access, analyze and report on CMS Intern amp; Resident Information System (IRIS) data and understand how this data applies to calculations used to determine hospital reimbursement for direct and indirect costs of a GME Program Compile case file documentation, analyze data, calculate findings, document and communicate reports of investigative findings and necessary corrective actions in accordance with applicable regulations, policies and procedures Apply in-depth knowledge of federal and state regulations and healthcare industry standardsCommunicate with providers regarding issues and questions surrounding program compliance and audit findingsDocument work performed and audit results based on standards and guidelines, including GAGAS Comprehend and follow auditing plans and methodologies specific to contract requirements Identify and recommend policy, procedure and system changes

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